荧光导航辅助下切除功能区恶性胶质瘤

Fluorescence-guided resection of malignant gliomas in the eloquent brain areas

目的探讨荧光导航技术在切除功能区恶性胶质瘤手术中的应用价值。方法对8例功能区恶性胶质瘤病人,术中利用荧光素钠将肿瘤染色,根据荧光影像判定肿瘤的边界并切除肿瘤。比较术中所见与病理组织检查结果。结果术后复查CT或MRI,肿瘤全切除7例(87.5%),次全切除1例。术后神经功能未受明显影响,无手术并发症。结论荧光引导技术具有实时导航,客观、安全、可靠等特点,能提高功能区恶性胶质瘤全切除率及降低手术并发症。

Objective To evaluate the utility of the fluorescence-guided system in resection of malignant gliomas in or near the eloquent region. Methods The fluorescence-guided system was used to resect the malignant gliomas near the eloquent region in 8 cases. The tumor was stained with sodium fluorescein and then resected after its border was judged based on the fluorescence image. The operative findings were compared with histological findings from the different areas of the malignant gliomas. Results Of the 8 cases, the postoperative imaging data revealed that total removal of the lesion was achieved in 7 （87.5%）, subtotal resection in 1. The postoperative neurological functions were not significantly affected. No operative complication attributed to use of fluorescence-guided system. Conclusions The fluorescence-guided system is reliable and safe. It can provide dynamic tracing of the tumor during the operation and guide the manipulation, thus being helpful to totally resect the malignant gliomas in or near the eloquent brain area, and reduce postoperative complications.